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KRONİK HEMODİYALİZ HASTALARINDA L-KARNITIN' İN SOL VENTRİKÜL FONKSİYONLARINA ETKİSİ: 6 AYLIK TEDAVİ SONUÇLARI

TH E EFFECT OF L-CARNITINE ON LEFT VENTRICULAR FUNCTIONS IN CHRONIC HEMODIALYSIS PATIENTS: THE RESULTS OF SIX MONTHS TREATMENT

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Abstract (2. Language): 
L-carnitine (L-C) deficiency seen in chronic hemodialysis (HD) patients may contribute to heart failure and arrhythmias, through damaging the myocardial energy metabolism. In this study, the effect of L-C treatment on left ventricular (LV) functions was investigated in chronic HD patients. Seventeen chronic HD patients (8 male, 9 female, mean age 41.3 years, range 21-73 years) were studied. Each patient was given L-C 2g a day peroral for 6 months. LV systolic and diastolic functions at the beginning and at the end of the treatment were assessed using M-mode and 2 D Doppler echocardiography. Diastolic function parameters were improved significantly while LV systolic functions did not change at the end of the six months of L-C treatment. No side effect was observed during treatment. Our results suggest that six months L-C treatment did not cause any change in LV systolic functions, on the other hand, diastolic functions improved significantly. Further placebo controlled, long-term clinical studies are needed to assess if there is any L-C effect on cardiovascular morbidity and mortality.
Abstract (Original Language): 
Kronik hemodiyaliz (HD) hastalarında görülen L-karnitin (L-K) eksikliği, myokardın enerji metabolizmasını bozarak, kalp yetmezliği ve aritmilere katkıda bulunabilmektedir. Bu çalışmada, kronik HD hastalarında L-K tedavisinin sol ventrikülfonksiyonlarına etkisi incelenmiştir. Çalışmaya yaş ortalaması 41.3 yıl (21-73), 8i erkek 9'u kadın olan 17 kronik HD hastası alınmıştır. Hastalara 6 ay süre ile günde 2 gram oral L-K tedavisi uygulanmıştır. Tedavi öncesi ve sonrası sol ventrikül sistolik ve diyastolik fonksiyonları, M-mode ve 2 D Doppler ekokardiyogra.fi ile değerlendirilmiş¬tir. Altı aylık tedavi sonunda sol ventrikül sistolik fonksiyonlarında değişiklik olmaz iken diyastolik fonksiyon parametrelerinde anlamlı düzelmeler ol¬muştur. Tedavi süresince ilaca ait bir yan etki gözlen¬memiştir. Sonuçlarımız, kronik HD hastalarında 6 aylık L-K tedavisinin sol ventrikül sistolik fonksiyonlarını de¬ğiştirmediğini ancak diyastolik fonksiyonlarda önemli düzelmeler sağladığını ortaya koymaktadır. L-K tedavisinin kardiyovasküler morbidite ve mortalite üzerine etkisinin anlaşılabilmesi için plasebo kontrol¬lü uzun süreli klinik çalışmalara gereksinim vardır.
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REFERENCES

References: 

1. Opie LH. Role of carnitine in fatty acid metabolism of normal and ischemic myocardium. Am Heart J 1979;97: 375-388.
2. Whitmer JT, Idell-Wenger JA, Rovetto MJ. Control of fatty acid metabolism in ischemic and hypoxic hearts. J Biol Chem 1978;253: 4305.
3. Pereira RR, Scholte HR, Luyt-Houwen IEM, Verduin-
Vaandrager MHM. Cardiomyopathy associated with carnitine loss in kidneys and small intestine. Eur J Pediatr 1988; 148: 193-197.
4. Neely JR, Robishaw JD, Vary JC. Control of myocardial levels of Co-A and carnitine. J Mol Cell Cardiol 1982;14
(Suppl.31): 37.
5. Engel AG. Possible causes and effects of carnitine deficiency in man. In:Frankel RA, McGarry D (eds), Carnitine Biosynthesis, Metabolism and Function.
Academic Press, New York 1980, pp 271-285.
6. Bartel LL, Hussey JL, Shrago E. Perturbation of serum carnitine levels in human adults by chronic renal disease
and dialysis therapy. Am J Clin Nutr 1981;34: 1314¬1320.
7. Mathew S, Menon PVG, Kurup PA. Effect of
administration of carnitine on the severity of myocardial infarction induced by isoproterenol in rats. Aust J Exp
18
Biol Med Sic 1986;64 (Pt. 1): 79-87.
8. Silverman NA, Schmitt G, Vishwanath M, Feinberg H, Levitsky S. Effect of carnitine on myocardial function and metabolism following global ischemia. Ann Thorac Surg 1985; 40: 20-24.
9. Rebouche CJ, Engel AG. Kinetic compartmental analysis of carnitine metabolism in the dog. Arch Biochem Biophys 1983;220: 60-70.
10. Di Palma JR, Ritchie DM, McMichael RF.
Cardiovascular and antiarrhythmic effects of carnitine.
Arch Int Pharmacodyn 1975;217: 246-250.
11. Kobayashi A, Suzuki Y, Kamikawa T. Effects of L-carnitine on ventricular arrhythmias after coronary reperfusion. Jpn Circ J 1983; 47: 536-542.
12. Suzuki Y, Kamikawa T, Yamazaki N. Effects of L-carnitine on ventricular arrhythmias in dogs with acute myocardial ischemia and a supplement of excess free
fatty acid. Jpn Circ J 1981;45: 552-559.
13. Rizzon P, Biasco G, Di Biase M,Boscia F, Rizzo U, Minafra F, Bortone A, Siliprandi N, Procopiot A, Bagiel-la E, Corsi M. High doses of L-carnitine in acute myocardial infarction: metabolic and antiarrhythmic
effects. Eur Heart J 1989;10: 502-508.
14. Kamikawa T, Suzuki Y, Kobayashi A, Hayashi H, Masumura Y, Nishihara K, Abe M, Yamazaki N. Effects of L-carnitine on exercise tolerance in patients with stable angina pectoris. Jpn Heart J 1984;23: 587-597.
15. Vecchiet L, Di Lisa F, Pieralisi G, Ripari P, Menabo R, Giamberardino MA, Siliprandi N. Influence of L-carnitine administration on maximal physical exercise.
Eur J Appl Physiol 1990;61: 486-490.
16. Tripp ME, Katcher ML, Peters HA. Systemic carnitine deficiency presenting as familial endocardial fibroelastosis: A treatable cardiomyopathy. N Engl J
Med 1981; 305:385-390.
17. Waber LJ, Valle D, Neill CA, DeMauro S, Shug AL.
Carnitine deficiency presenting as familial cardiomyopathy: A treatable defect in carnitine
transport. J Pediatr 1982;101: 700-705.
18. Savica V, Bellinghieri G, Di Stefano C, Corvaja E, Consolo F, Corsi M, Maccari F, Spagnoli LG, Villaschi S, Palmieri G. Plasma and muscle carnitine levels in haemodialysis patients with morphological-ultrastructural examination of muscle samples. Nephron 1983;35:232-236.
19. Fagher B, Thysell H, Nilsson-Ehle P, Monti M, Olsson
L, Eriksson M, Lindstedt S, Lindholm T. The effect of D, L-carnitine supplementation on muscle metabolism, neuropathy, cardiac and hepatic function in hemodialysis
patients. Acta Med Scand 1982;212: 115-120.
20. Casciani CV, Caruso U, Cravotto E, Corsi M, Maccari F. Beneficial effects of L-carnitine in post-dialysis syndrome. CurrTherap Res 1982;32: 116-126.
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